Porokeratosis: A Review of Its Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment

Actas Dermosifiliogr (Engl Ed). 2020 Sep;111(7):545-560. doi: 10.1016/j.ad.2020.03.005. Epub 2020 May 13.
[Article in English, Spanish]


Porokeratosis comprises a group of heterogeneous and uncommon acquired or congenital skin diseases of unknown origin characterized by a keratinization disorder resulting from abnormal clonal expansion of keratinocytes. Numerous genetic mutations are thought to be involved. These conditions are characterized histologically by the presence of a cornoid lamella. Clinical manifestations are variable, with localized, disseminated, and even eruptive forms. Porokeratosis has been associated with immunosuppression, ultraviolet radiation, and systemic, infectious, and neoplastic diseases. Many authors consider it to be a premalignant condition because of the potential for malignant transformation to squamous cell or basal cell carcinoma. Therefore, long-term follow-up is a key component of treatment, which is usually complex and often unsatisfactory. We review the latest advances in our understanding of the pathogenesis, diagnosis, and treatment and propose a treatment algorithm.

Keywords: Cáncer cutáneo; Eruptive porokeratosis; Linear porokeratosis; Neoplasias; Neoplasms; Porokeratosis; Porokeratosis of Mibelli; Poroqueratosis; Poroqueratosis de Mibelli; Poroqueratosis eruptiva; Poroqueratosis lineal; Skin cancer.

Publication types

  • Review

MeSH terms

  • Cell Transformation, Neoplastic
  • Humans
  • Porokeratosis* / diagnosis
  • Precancerous Conditions*
  • Skin Neoplasms* / diagnosis
  • Ultraviolet Rays